82例肝动脉灌注化疗致过敏反应患者的临床特征及护理对策

Clinical features of patients with allergic reactions induced by hepatic arterial perfusion chemotherapy and its nursing strategy:preliminary results in 82 patients

目的探讨肝动脉灌注化疗致过敏反应的患者临床特征及护理对策。方法分析82例患者过敏反应的临床表现、严重程度分级、发生时间、高危药物、过敏性休克的首发症状等。结果82例患者中57例(69.5%)为肠癌肝转移,年龄42~82岁,多数为对奥沙利铂过敏(98.8%),Ⅰ度过敏反应常见(80.5%),临床表现以皮肤症状为主,多种症状可同时出现,过敏反应可发生于用药各个时间段,过敏性休克多发生于用药后30 min内,首发症状不典型。结论奥沙利铂是在肝动脉灌注化疗中导致过敏反应的常见药物,护理人员应熟悉相关药物过敏反应,尤其是过敏性休克的临床症状、特点、护理措施,确保患者治疗安全。

Objective To investigate the clinical features of patients with allergic reactions induced by hepatic arterial perfusion chemotherapy,and to discuss its nursing strategy.Methods The clinical manifestations,severity grading,time of onset,high-risk drugs,and the initial symptom of anaphylactic shock in 82 patients with allergic reactions were analyzed.Results Of the 82 patients,57(69.5%)had liver metastases from colorectal cancer,aged 42-82 years.Most patients(98.8%)were allergic to oxaliplatin.Degree I allergic reaction was most commonly seen(80.5%),and the clinical manifestations were mainly skin symptoms.Multiple symptoms could occur at the same time.The allergic reactions could occur in various time periods of medication,and anaphylactic shock usually occurred within 30 min after medication,and the initial symptom was atypical.Conclusion Oxaliplatin is a common drug that may cause allergic reactions in patients receiving hepatic artery infusion chemotherapy.Nursing staff should be familiar with the relevant drug allergic reactions,especially the clinical symptoms,features,and nursing measures of anaphylactic shock,so as to ensure the safety of patients.